Malawi - Demo Subnational HIV Estimates

Naomi estimates for December 2018 (report generated 07-11-2022)

Methods

Naomi is a small-area estimation model for estimating HIV prevalence and PLHIV, ART coverage, and new HIV infections at district level by sex and five-year age group. The model combines district-level data about multiple outcomes from several sources in a Bayesian statistical model to produce robust indicators of subnational HIV burden.

Comparison of Naomi model estimates to data inputs

Household Survey

Cross-sectional estimates for HIV prevalence, ART coverage, and HIV incidence are produced at the mid-point of the most recent nationally representative household survey. For HIV prevalence, the model is calibrated to survey data about HIV prevalence by subnational level, sex, and five-year age group from the most recent population-based survey (for example Population HIV Impact Assessment survey or Demographic and Health Survey).

This report compares Naomi estimates for December 2018 to the following population-baes survey(s):

Household Survey

  • National household survey data on HIV prevalence from DEMO2016PHIA, DEMO2015DHS
  • National household survey data on ART coverage from DEMO2016PHIA

We anticipate that the Naomi estimates will be closely aligned with the survey estimates at a national level. Some variation is expected between model estimates and survey estimates at lower Admin levels where survey estimates may be sparse for certain age and sex groups.

We anticipate that the Naomi estimates will be closely aligned with the survey estimates at a national level. Some variation is expected between model estimates and survey estimates at lower Admin levels where survey estimates may be sparse for certain age and sex groups.

We anticipate that the Naomi estimates will be closely aligned with the survey estimates at a national level. Some variation is expected between model estimates and survey estimates at lower Admin levels where survey estimates may be sparse for certain age and sex groups.

Geographic distribution

Age distribution

Static images of individual plots can be downloaded by hovering on the right hand corner

Static images of individual plots can be downloaded by hovering on the right hand corner

Static images of individual plots can be downloaded by hovering on the right hand corner

Routinely collected programme data:

For the HIV prevalence and ART coverage components of the model, ART service delivery numbers inform subnational estimates for the number of PLHIV. Since the Household survey sample size in each district is relatively small, routinely reported data about HIV prevalence among pregnant women attending their first antenatal care visit, extracted from the national health information system, are used to improve estimates of the spatial pattern of HIV.

This report compares Naomi estimates to:

  • National programme data on numbers on ART for March 2016 and December 2018
  • National programme data on ANC HIV prevalence for 2016 and 2018
  • National programme data on ANC ART coverage for 2016 and 2018

The plots below compare ANC programme to age and sex matched estimates of the general population produced by Naomi. While these data should be positively correlated, we expect higher HIV prevalence and ART coverage in all females ages 15-49 relative to women attending antenatal services.

Version

The Naomi model is supported by UNAIDS and developed and maintained by the MRC Centre for Global Infectious Disease Analysis at Imperial College London. The model receives technical guidance from the UNAIDS Reference Group on Estimates, Modelling, and Projections. The model was first used in 2020 and continues to be developed responsive to new data and HIV strategic information needs.